Efficacy of standard large trauma craniotomy combined with temporal horn opening of lateral cerebral ventricle in 85 patients with severe traumatic brain injury

HE Xu-zhi; XU Lun-shan; XU Min-hui; WANG Hao; WANG Xu-hui

Abstract：Objective To study the efficacy of standard large trauma craniotomy combined with temporal horn opening of lateral cerebral ventricle in severe traumatic brain injury .Methods Retrospective analysis was ap-plied to 245 cases of severe traumatic brain injury treated with standard large trauma craniotomy from Jul .2003 to Jul.2013 in our hospital.Patients in group A(n=85)were treated with standard large trauma craniotomy and in-tracranial hematoma removal or frontal and temporal pole resection ,and lateral cerebral ventricle temporal horn open-ing.Patients in group B(n=90)were treated with standard large trauma craniotomy and intracranial hematoma re-moval or frontal and temporal pole resection .Patients in group C(n=70)was treated with only standard large trau-ma craniotomy.Clinical data were collected such as gender,age,preoperative GCS(Glasgow coma scale),time length from injury to operation,pupil size,CT(computer tomograph),BP(blood pressure),arterial partial pressure of oxygen,and glucose.Based on the GOS(Glasgow outcome scale),the treatment efficacy at 6 months after operation was compared among the three groups .Results The rates of good or mild to moderate disability of group A ,B and C were 23.5%, 20.0%, 20.0%, respectively;the rates of severe disability or persistent vegetative state were 50.6%,47.8%,40.0%,respectively;and the mortality rates were 25.9%,32.2%,40.0%,respectively .Ridit a-nalysis with the application of SPSS 15.0 statistical software showed F =3.37 and P=0.0371.Conclusion In se-vere traumatic brain injury ,the efficacy of standard large trauma craniotomy accompanied with intracranial hematoma removal or frontal and temporal pole resection , and temporal horn opening of lateral cerebral ventricle is better in mortality decrease than the other two treatments of standard large trauma craniotomy and intracranial hematoma re -moval or frontal and temporal pole resection and merely standard large trauma craniotomy ;yet such treatment fails to increase the rate of good or mild to moderate disability at 6 months after surgery .